Nonopioid Approaches to Pain Management in Chronic Kidney Disease

Emily Lu; Holly M Koncicki

doi:10.1016/j.semnephrol.2021.02.006

Nonopioid Approaches to Pain Management in Chronic Kidney Disease

Semin Nephrol. 2021 Jan;41(1):54-67. doi: 10.1016/j.semnephrol.2021.02.006.

Authors

Emily Lu¹, Holly M Koncicki²

Affiliations

¹ Division of Nephrology, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: emily.lu@mssm.edu.
² Division of Nephrology, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

PMID: 33896474
DOI: 10.1016/j.semnephrol.2021.02.006

Abstract

Patients with chronic kidney disease (CKD) and end-stage renal disease experience high pain and symptom burden, but management of chronic pain in this population remains challenging. Recent studies have shown a high rate of opioid prescription and use in patients with kidney disease. However, the concern for opioid-related morbidity and mortality suggests a need to reconsider the safety and efficacy of opioid use in patients with CKD. In this review, we describe the current approaches to pain management in CKD, highlight the evolving opioid-related risks and kidney-specific concerns, and offer both pharmacologic and nonpharmacologic nonopioid strategies for pain management in patients with kidney disease, emphasizing the importance of using a multimodal approach to optimize pain control.

Keywords: Opioid; chronic kidney disease; nonopioid; pain management.

Publication types

Review

MeSH terms

Analgesics, Non-Narcotic*
Analgesics, Opioid / therapeutic use
Chronic Pain* / drug therapy
Humans
Pain Management
Renal Insufficiency, Chronic* / complications

Substances

Analgesics, Non-Narcotic
Analgesics, Opioid